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Question 1
I would recommend individual treatment to start due to Jacinta’s symptoms of anxiety, listlessness, despondency, and low self esteem.
I would focus on client engagement to explore ambivalence about treatment and introduce grounding techniques and inquire about the ways she copes. I would explore Jacinta’s willingness to be seen by a psychiatrist to help with insomnia, anxiety, and explore possible delusions. Medication can be helpful for a period of time to help reduce some of her symptoms so she can engage in treatment.Question 2
I would inquire what Jacinta’s beliefs are regarding Susto and what events in her life have led to her being unhappy and anxious. I would inquire if she has knowledge about interventions or healing techniques that have been helpful for others who have suffered from Susto.Question 3
I would ask Jacinta’s if she is comfortable joining a Seeking Safety group for women. If not I would continue to work with her individually until she is feeling safe and comfortable to join the group.Question 4
I appreciate learning about the various tools for assessing trauma and the different modalities of treatment. The exercises were helpful with reflecting on my practice and how my work place applies many components of TIC.Question 1
I was astonished with Christina’s resiliency and determination. Christina took control of her treatment by researching a therapy that could help her, built a relationship with a therapist, set goals for herself, and has decided to try and make a difference for others who come into “ “the system”. Christina has kept a steady job, been promoted, and continues her education. She knows that supports are important and continues to be a part of a support group.
If I were working with Christina I would help assist her with maintaining a positive outlook, support her in her future goals, and inquire about her spirituality.Question 2
I have used the ACE to learn the types of trauma clients have experienced in childhood to help understand their behaviors and how this effects school performance and the high risk behaviors the adolescents I work with engage in. This tool needs to be used with care because it could bring up past events clients are not prepared to discuss. PCE is the other tool that I use to understand the positive experience in order to understand their sense of belonging and connection.
PTSD checklist is the other tool I have used to screen clients for PTSD. This is helpful to discuss client’s symptoms and ways to cope. This tool is not a diagnostic tool simply for screening and provisional diagnosis.Question 3
With Selena I would start by building trust, normalizing symptoms, and ask her to journal about her thoughts and feelings related to the trauma. Teach mindfulness of emotions to help with the emotions she might be avoiding around bedtime. Ask her to check in with PCP to inquire about medication to help with nightmares for a period of time. Education around sleep hygiene and ways to self soothe.
Encourage and explore peer support groups.Question 1
Leadership in my work place have made it mandatory for all staff to receive training on how trauma effects behavior and learn prevention strategies to intervene so situations do not escalate to a crisis. The organization keeps track of the crisis situations that occur within the organization and this information is shared with staff and discussions are had on ways to improve the use of prevention strategies.
There is a council that meets monthly that is open to consumers who utilize services provided by the organization. Ways to improve services and unsatisfactory experiences are discussed. This information helps the organization improve delivery of services.
Clinicians collaborate with community service providers when specialized services are needed for consumers that are out of the organizations scope of practice. These often include trauma from domestic violence, human trafficking, and sexual abuse.Question 2
My strengths from the competencies are understanding the need for people with trauma histories to have emotional connections with safe people that can help people flourish and move forward. At the foundation of the work that I do is ensuring emotional and physical safety of clients in order to help stabilize them from a crisis and assist with maintaining stability at home and in the community.
I understand and have yearly training on the importance of not confronting unhealthy behaviors that might activate acute stress reactions or trauma symptoms and that the use of empathic listening creates understanding and this helps to guide resolution.
Being clear about rules and boundaries helps with keeping the environment safe and when people are unclear about the rules and boundaries this most often leads to behavioral and psychological acting out in unhealthy ways.
Having a strengths based lens has helped clients focus on their strengths, their accomplishments, and the healthy ways they have learned to cope and build resilience to recover from difficulties in their lives.
People of diverse cultures rarely access the services provided by the organization I work for. So I’m deficient in how trauma affects them and how they understand behavioral health treatment. I would like more knowledge on specific screening tools to screen and assess trauma histories with clients.
Lastly I could benefit from learning additional self care activities and ways to recognize STS in myself.
These competencies are important to know and practice because majority of people seeking services have a trauma history and if one is not competent then consumers struggle to get the help they need and as providers we may become frustrated with clients and this can lead to emotional distress.Question 3
Larry appears to be in the habit of confronting based on his skill set and could benefit from supervision and education. I wonder if a Larry is aware of the details of the client’s trauma history.
As a clinical supervisor the 12 step training would not have been my first recommendation. I would have focused on client centered approaches and trauma informed skills.Question 1
Shocking to hear that not one professional was able or willing to hear Anna’s story. Her art work would have been a great place to start to inquire. We as humans are constantly adapting to events and distress in our lives. It is short sighted to focus on symptoms and diagnosis, without looking at the big picture of peoples lives and their experiences.
Listening is at the foundation of the work that we do as social workers and other professionals in the mental health field. It has become harder to spend the time that it takes to listen to someone’s story. As providers we can get caught up in the insurance companies expectations and feeling as though we need to be giving advice or asking the client to have an action plan.Question 2
The paradigm shift to, how do I understand this person, is an important one. People are not problems to be solved. People are unique and have unique experiences. To understand someone we have to listen to them and come along side of them in order to help.
I recently worked with a twelve year old and her parents. Parents were concerned with their daughters lack of communication, isolation, and running away. The twelve year old was home with her older sister after school for several hours until parents got home from work. Her sister was bullying her both verbally and physically. When the twelve year old was ready to talk about her sister bullying her as well as being bullied at school by peers her symptoms were understandable. She was afraid to talk about the bullying because of her sister’s threats and she was concerned what the consequences would be if she told personnel at school.Question 3
I facilitate groups daily and encourage the participants to validate one another and to share their experiences. The environment is highly structured and predictable and this helps clients feel safe. Training for paraprofessional’s on strength based approaches is lacking.
